Testing the benefits of expressive writing in youth

Adolescence can be a very stressful time. Teenagers often have to deal with a range of issues, from bullying to conflicts with friends to problems with family members. Helping adolescents foster resilence, regulate their emotions and develop other health behaviours to deal with stress and adversity has been shown to lead to better mental health outcomes in both the short and long term. School-based programs that promote emotional well-being, especially for adolescents at risk of developing psychosocial problems, are urgently needed

Expressive writing (EW) is one method that has been shown to have a positive effect on mental health. In an expressive writing intervention, participants disclose details and emotions associated with a stressful or difficult past event, in the form of a written narrative, with the aim of more fully understanding the negative emotions triggered by the event. (For more information on expressive writing, please see the sidebar).

Though there have not been extensive studies involving adolescents and expressive writing, research conducted with this age group has shown that expressive writing can contribute to the reduction of internalizing problems and problem behaviours as well as to the improvement of social adjustment, school participation, and school performance.

For this particular grant, Principal Investigator Dr. Danielle Groleau and her team are conducting a formal evaluation of the Kids Write Network (KWN) - a brief school-based intervention that uses expressive writing to promote mental health and well-being among youth. It is a creative intervention in which children and adolescents are assisted by a facilitator to reflect deeply on a stressful or difficult event they have experienced or witnessed (e.g., bullying, conflict with significant others), find positive ways to cope with similar situations, and ultimately lead them to write and illustrate a story based on real events to be published. The goals of this expressive writing intervention are to enhance self-expression, self-esteem, and self-confidence and also to develop a sense of agency and voice in participating children.

The faciltator works with participating children within a 5-step process (brainstorming, characters, settings, conflict-resolution, ending - moral lesson) with the objective, for each participating child, of writing a story to be self-illustrated and published within two weeks after the manuscript is completed. To date, over 1000 children have participated in the program and 85 books have been published.

The team is using a mixed-methods design to document the implementation process of the KWN, to understand the experience of participating children, and to measure mental health outcomes. The data collected from this pilot project will be used to develop a future randomized control trial on the intervention. Results from the team’s evaluation will also contribute to the published knowledge on expressive writing and adolescents in the area of school-based mental health promotion programs.

To date, the grant has enabled the team to develop a theoretical model for this intervention, tested the suitability of mental health outcome measures and qualitative methods to collect and code the qualitative data, and identify appropriate recruitment strategies for a school-based randomized controlled trial (RCT). They are in the process of documenting and analyzing students’ experiences and psychological processes and are currently preparing to evaluate students’ mental health outcomes as a result of the intervention in two schools.

Provided that the randomized control trial yields positive mental health outcomes for students in the next year, the expressive writing intervention will be implemented in more schools as a school-based mental health promotion intervention, accompanied by implementation guidelines.

“If positive mental health outcomes are exhibited, the current research will provide teachers and schools with a low-cost and low-technology school-based program to promote wellbeing and self-esteem among teenagers. Our prospective results should also significantly contribute to the advancement of mental health literature on children in a school-based setting.”
— Danielle Groleau, McGill University

What is expressive writing?

Expressive writing is a form of intervention that involves writing down thoughts and feelings that arise from a stressful or traumatic event. Developed by Dr. Pennebaker in the 1980’s, expressive writing has been shown to help in coping and may also have a positive impact on stress and anxiety.

Studies have shown that expressive writing can have positive benefits in: